South African Insurance Association (SAIA)

The Easter travel period sees a significant increase in road usage across South Africa, as individuals travel for family engagements, religious events, and holidays.

Despite ongoing road safety efforts, this period remains one of the most dangerous on the national road network.

While road safety discourse often focuses on fatalities, enforcement, and infrastructure, insurance claim trends, particularly rejected claims following accidents, provide critical insights into unsafe driving behaviour.

Data from the Insurance Data System (IDS) and findings from the National Financial Ombud Scheme (NFO) demonstrate how driver conduct, vehicle condition and compliance with legal requirements directly influence both accident outcomes and claim decisions.

The IDS is a database of claims data submitted by insurance company members of the South African Insurance Association (SAIA). Not all insurers participate in the IDS, but the aggregated data provides insights into claims trends.

IDS data shows that a notable portion of claims repudiations is associated with road safety risks and breaches of duty of care.

Beyond accident statistics reported by the Road Traffic Management Corporation (RTMC), rejected claims represent a significant and often overlooked consequence of unsafe driving.

These trends reinforce that road safety is not only a regulatory concern, but fundamentally a behavioural one.

Rejected claims reflect risky road behaviour

Insurance is intended to provide financial protection after an accident. However, claims may be declined where policy conditions are breached, or negligence is evident. Understanding these factors is essential for both financial protection and the promotion of responsible driving behaviour on South Africa’s roads.

A significant proportion of disputes handled by the NFO relate to motor vehicle claims, reflecting the prominence of road-related incidents in overall insurance complaints.

Motor claims continue to represent a large share of cases referred for determination, with many disputes arising from rejections linked to policy exclusions or a failure to exercise reasonable care.

Although rejected claims account for approximately 10% of the total annual claims in the non-life insurance industry, this proportion has shown a decline since 2020.

Despite this improvement, the underlying pattern remains consistent: most repudiations are driven not by administrative or technical factors, but by preventable driver behaviour and non-compliance with traffic regulations and responsible driving practices.

Key behavioural factors behind rejected motor claims

Analysis of IDS sampled data and NFO case trends highlights several recurring causes for rejected motor insurance claims:

1. Driving under the influence

Driving while intoxicated remains one of the most common reasons for claim repudiation and leading contributor to fatal crashes. If a driver is found to be over the legal alcohol limit at the time of an accident, insurers may reject the claim because the driver violated both the law and the policy conditions.

This exposes motorists to significant financial risk, as they may be held personally liable for damage to their own vehicle as well as any third-party losses.

2. Excessive speed and reckless driving

Speeding, racing, ignoring traffic signals and aggressive driving behaviour are among the most common forms of reckless driving.

Where evidence indicates that excessive speed – “gross negligence” – contributed to the accident, claims may be repudiated under the “reasonable precautions” clause in that the driver failed to take reasonable care.

From a road safety perspective, this aligns with national traffic enforcement priorities, where speeding remains a leading cause of accidents.

3. Unroadworthy vehicles

Vehicle condition is another recurring factor. Claims may be rejected where the vehicle involved in the accident is found to be unroadworthy or if the accident was caused by poor vehicle maintenance; for example, worn tyres below the legal limit or defective brakes.

Such cases highlight the intersection between vehicle maintenance and accident prevention. Pre-trip vehicle checks are essential, especially for long-distance Easter travel.

4. Unlicensed or unspecified drivers

Insurance policies typically require that drivers be licensed and correctly disclosed at underwriting stage, that is, when the policy is first taken out. Claims may be declined if the vehicle is driven by an unlicensed or undisclosed driver at the time of the accident.

This issue is particularly relevant during holiday travel periods, when vehicles are frequently shared among family or friends.

5. Misrepresentation or non-disclosure

Insurance policies rely on accurate information. Claims may be rejected if:

• The driver misrepresents the circumstances of the accident;
• Damage occurred before the reported incident; or
• There is evidence of insurance fraud.

Fraud not only results in rejected claims but can also lead to criminal prosecution.

Rejected claims often highlight behavioural patterns that contribute directly to accidents. In this sense, insurance data provides a valuable lens for understanding driver risk.

Three clear lessons emerge:

1. Risky driving behaviour carries financial consequences. Motorists may lose both their claim payout and become liable for third-party damages;
2. Vehicle maintenance and compliance matter. Roadworthy vehicles are a critical component of accident prevention; and
3. Policy understanding is part of responsible driving. Consumers must understand their contractual obligations and legal responsibilities.

By choosing safer driving behaviours motorists can help decrease road fatalities while also shielding themselves from the financial shock of rejected insurance claims.

Road safety is not only about avoiding penalties or accidents - it is about accountability, responsibility, and protecting lives.

As South Africans take to the roads this Easter, the message is clear: Drive responsibly. Arrive safely. And make sure your actions don’t cost you more than the journey itself.